Carl Roy told directors on the Peace River Regional District board yesterday that he has been appointed to oversee those changes as responsibility for the ambulance service is being transferred to the Provincial Health Services Authority.
"Clearly there has been a lot of talk about improvement, and the transfer into the health sector gives us a chance to really take some action," said Roy, who is also a senior vice president with the province-wide health authority responsible for delivering specialized health services.
Roy said a big issue for rural communities is recruitment and retention of paramedics, and that the current system of having on-call medics who are paid when calls are received is not working.
"We need changes in the system," he said. "I just don't know how you sustain a system by saying to people, 'we will train you up and then we'll pay you $2 an hour.'"
He said because volumes of emergency work and patient transfers are not enough in many rural communities to create gainful employment, the commission, in cooperation with the health sector, want to look at expanding the role of paramedics in providing health services. He said this could include supporting staff in health facilities, but also expanding the role of paramedics in pre-hospital health.
"The opportunity here now is to work at the work we do now in BC Ambulance Service within the broader context of the healthcare team, and the needs of populations, and rural and remote BC will be getting some special attention," said Roy.
However, he said a huge challenge will be to integrate the current collective agreement into the collective agreement of the larger health sector unions.
He said the concept was conceived several years ago but not much has been done to implement it. However, he said in collaboration with Northern Health they are close to implementing a pilot project in Smithers, with the hope of translating that to other communities.
He added they are anticipating improved training in the North.
"We have to change our whole system for how we look at training and supporting people," said Roy. "It's largely been left to them, as it is with nurses, to advance their skill set, and we know that's not the model that's in our best interest, so we're changing that."
Roy said another challenge in rural communities is the competition for skilled medics by industry.
"We have to get in there and look at the impacts, and most of all we have to eliminate what is a considerable gap in compensation in what industry pays and what BC Ambulance pays," he said. "That's easy to say, but it won't happen unless it happens around the bargaining table."
He said having a province-wide ambulance service has many advantages, but they are looking for ways to make the system more efficient and responsive.
"We have set for ourselves a target for improving the way we transfer patients into a higher levels of care," said Roy. "It has been a fragmented system. I suspect by the end of the year we will have a provincial transfer network designed and ready to go for 2012."
He said while other first responders play a critical role in supporting pre-hospital care, there is currently no direction from the government towards a province-wide integration of fire departments and ambulance services. He said as it stands now, it's up to local governments to decide whether other first responders participate in providing pre-hospital care, though training support and supplies are available at the provincial level for other first responders to do that work.
"We're also looking at how we improve our overall oversight of that work that gets done – not only for paramedics, but we'll be doing the same for other first-responder agencies as well – so there will be some real-time support from physicians who will operate out of our dispatch centre," Roy added.
Mike Michalko, executive director for the North with the Emergency and Health Services Commission, provided some operational details of some of the efforts ongoing in the region. He said, for example, core training was provided recently to a group of interested residents from Tumbler Ridge and surrounding areas. He added the would be announcing shortly a program to provide primary care paramedic training in the region in collaboration with the Justice Institute of BC.
He said, however, more training will be required to fully integrate into the health sector.